MEDICATIONS: ACPM RECOMMENDS SCREENING FOR HEPATITIS C AMONG HIGH RISK GROUPS

Oct. 21, 2004 — ACPM recommends that individuals at high risk for chronic hepatitis C infection be screened for hepatitis C by an FDA-approved screening test, followed by a confirmatory test where the low signal cutoff (S/C) ratio indicates a less than 95 percent chance of infection.

Risk factors include injection drug use (IDU), sexual exposure to individuals with IDU, and a history of receiving blood or blood products before 1992. The College does not find sufficient evidence to recommend for or against universal screening.

Hepatitis C is an under-diagnosed blood-borne illness, resulting in chronic cirrhosis in up to 25 percent of those infected. While the overall prevalence in the U.S. is low (1.7 percent), high risk populations may have up to 80 percent prevalence. Current screening practices are inadequately identifying infected individuals, causing ongoing spread of the virus and resulting in under-treatment.

ACPM's recommendations were adopted on Sept. 30 by ACPM's Board of Regents. The practice policy statement has been submitted to the American Journal of Preventive Medicine for publication.